Clinical features and risk factors of metabolic syndrome in adult hypopituitary patients

Abstract

Objective: To investigate the clinical features and risk factors of metabolic syndrome (MS) in adult hypopituitary patients (HP). Methods: Patients diagnosed with HP in the outpatient or inpatient department of the endocrinology department in West China Hospital from January,2012 to December,2019 were selected as the experimental group (HP group), and patients with normal pituitary function treated for saddle lesions were selected as the control group. HP patients with or without MS were divided into MS group and non-MS group HP patients were divided into four groups according to the level of growth hormone by the quartile method (GH>0.35 μg/L、0.13 μg/L<GH≤0.35 μg/L、0.05 μg/L<GH≤0.13 μg/L and GH≤0.05 μg/L). And then we compared the differences in clinical characteristics between groups. Results: A total of 264 patients with HP (136 males, 51.5%) and 53 patients with normal pituitary function (22 males, 41.5%) were included. There were no significant differences between the two groups in age[(41±13)vs(40±12) years old] and body mass index(BMI)[(23.3±4.5)vs(23.1±3.9) kg/m2]. Delays in diagnosis and treatment were common in HP, and less than 50% of HP patients received standard alternative therapy. The prevalence of MS (39.4% vs 24.4%) and non-alcoholic fatty liver disease (30.9% vs 12.5%), waist circumference [(87.2±10.6) vs (82.2±12.6) cm], triglyceride [M(Q1,Q3)1.81(1.15, 2.83) vs 1.14(0.80, 1.69) mmol/L] in HP group were higher than those in control group (P<0.05). Blood pressure [systolic blood pressure:(112±19) vs (124±16) mmHg; diastolic blood pressure:(70±12) vs (81±12) mmHg; 1 mmHg=0.133 kPa] and HDL cholesterol [1.06(0.83, 1.35) vs 1.49(1.14, 1.78) mmol/L] in HP group were lower than those in control group (P<0.05). The levels of GH [0.11 (0.03, 0.35) vs 0.20 (0.05, 0.41) μg/L] and IGF-1 [58.33 (38.12, 76.03) vs 65.54 (51.78, 101.76) μg/L] in MS group were lower than those in non-MS group (P<0.05). The lower the GH level(GH>0.35 μg/L、0.13 μg/L<GH≤0.35 μg/L、0.05 μg/L<GH≤0.13 μg/L and GH≤0.05 μg/L) in patients with HP, the higher the prevalence of MS (25.5%, 30.0%, 42.9%, 48.6%, P=0.031). Conclusions: The prevalence of MS in adult HP patients is higher than in patients with normal pituitary function. Abdominal obesity and dyslipidemia are the main components of MS, and GH deficiency is related to MS in HP patients.